Musculoskeletal injury as a trigger for fibromyalgia/posttraumatic fibromyalgia

The issue of musculoskeletal injury as a trigger for fibromyalgia (FM) is controversial. The present review critically evaluates the evidence that trauma can initiate FM, specifically addressing the scope of the problem, the issue of causality, possible pathophysiologic mechanisms, and medicolegal aspects. One major problem is the fact that most of the data come from anecdotal reports and small case series and not from controlled prospective studies. Overall data from the current literature are insufficient to indicate whether causal relationships exist between trauma and FM. However, recent reports suggest that soft tissue trauma to the neck can result in an increased incidence of FM compared with other injuries. Future studies should prospectively document the chronology of symptoms from the onset of trauma and repeatedly evaluate the patients for disability, quality of life, change in occupation, and litigation status.